Healthcare as a System

Healthcare should be an integrated system. In the U.S. it is nothing of the sort. All the participants - patients, doctors, hospitals, HMOs, employers, drug companies, insurance companies and the government - are working at cross purposes. The result is chaos - expensive chaos. We need a unified, universal and national healthcare system that coordinates all healthcare activities.

Let's start with the patient. If he has a job with good healthcare insurance, he depends on his employer for information. If his employer does not provide insurance, he is at the mercy of the so-called health market. If he can't afford insurance, he is completely caput. Generally, the patient is confused.

The doctor is the good guy - usually. But he often has to fight with insurance companies and with HMOs and with the government to provide the care he deems necessary. He is burdened with both commercial and government red tape.

Hospitals charge outrageous prices for lousy service. It costs more to spend a night at a crummy hospital than at the Waldorf Astoria Hotel. An aspirin tablet may cost $10. At times the wrong medicine is given to you. Often instead of being cured you pick up an infection when staying at the hospital. They have a fancy name for this: iatragenic. And let's not even talk about the horrors in the emergency room.

HMOs supposedly provide good care more efficiently. In reality, the HMO management fights with doctors to try to prevent the patient from consulting with expensive specialists and from seeking expensive surgery. HMOs too often work to reduce patient care.

Insurance companies work to reduce patient care, as well. First, they cherry pick healthy customers. Then they deny services when a customer gets very sick.

Drug companies with their advertising cause many to pester their doctors for drugs they do not need. And those that do need the drugs, pay an inordinate price.

Employers don't want to be involved. Running a healthcare benefit program is a distraction. They do it in order to keep their employees.

The federal government runs a few good programs, such as Medicare and Veteran and Congressional health programs. Each of the states has its own program. It's a complicated mess.

All these people and organizations, working on their own health agenda, produces havoc. Increases health expenses. Reduces health benefits. Leaves many people without protection. Even rich people with excellent insurance may be adrift.

When it comes to health, what happens to one individual may affect other individuals. One individual gets an infection and spreads it around to others. A child gets a rare disease and his father can't do his work properly, thus hurting the business of his employer. The mother of an employee gets Alzheimer's and suddently the employee's medical bills zoom.

A person without health insurance causes extra problems. He does not visit the doctor for minor pains and infections. When he gets a severe case of the flu, he goes to the hospital emergency room (ER). Since the ER is crowded (because of poor patients like him), he must wait, thereby causing further medical complications.

Now, another individual who may have excellent insurance - what Bush calls "gold plated" - has a heart attack. He calls the doctor's office, and is told to take an ambulance to ER. He gets to the ER and then because of the confusion and overcrowding his care is delayed and he suffers unnecessarily. Sometimes the overcrowding is so great, ER does not accept the heart-attack patient and the ambulance proceeds to another hospital with even graver results - such as death.

The vast majority of our healthcare problems are due to the fact that it is not a system. In a real system the activities of all participants are coordinated in such as way as to produce better efficiencies and better health for all. Incremental changes, such as those proposed by President Bush, will cause further chaos.

We need one universal healthcare system run by the federal government.

In Europe, they have national health care and they are healthier and live longer than Americans. And don’t give me that crap about “waiting lists.” We have 45 million Americans on a waiting list just to get affordable insurance.

The American health insurance industry spend 20% of its money on administrative costs. Medicare spends 3%. Who’s more efficient?

And much of that 20% is actually spent DENYING health care to people, denying valid claims, dropping coverage, etc. So much of what we spend on health care in the US is actually anti-health care.

To here some people say we can’t let the goverment run our health care system because they can’t do anything right is a flat out lie. If that was true we would not have the hiway system or medicare {that works very well thank you} or our armed forces again the best in the world. I belive it’s just greed on the part of some people or maybe a lack of understanding of what is like to lose ones coverage or worse to have never had any at all. Feel very lucky if you have health care because someday you may not I know I was there because of layoffs. You wake with out a job no health care and hope the kids don’t get sick.

A single payer system seems to me to be the way to go. Privatization of the health care system has failed miserablely. Those in fear of the government running the health care system need to look beyond the Bush years as this administration has been such a failure in almost all things. Look to more competent public servants as the CEO as President experiment has failed along with privatization.

Military health care is great even for dependents. There is not a lot of red tape to see a doctor in the military He get’s paid according to his rank. Civilian Doctors get anywhere from $80 to $150 per visit not bad money when you can see up to 12 patients per day. Then you have hospital stays which cost anywhere from $400 to $1500 per day. Do you really think if the federal government takes over our medical care will be better? Do you expect the same care from a doctor who was making $500,000 per year but the government pays him only $100,000 per year. The medical system in Europe still cares for the patient. Doctors in the U.S. care about the almighty dollar. I have insurance but more than a few times I was turned away from seeing a doctor because I didn’t have the co pay.

Kap, the major problem we have now is that we rely upon emergency care to make up for a lack of preventative care.

The focus of medicne on profits leads to the development of paths that lead us away from cheap options. No profit, no development. I have no problem with for profit medicine, just don’t subsidize it with balooning medicare due to this last ditch, emergency room approach.

Everyone in the chain needs to make their high profit. Everyone in medicine is paid well. Their are stringent education requirements that makes this an exclusive club. Perhaps there should be a cost to join this club beyond education. Perhaps a commitment to humanitarian principles should be enforced through community service.

When people fail to recognize the cost shift to medicare and their own high insurance costs (that employers are now attempting to avoid) by saying they are against government intervention are simply out of touch with reality. Shifting costs to the buyer is an answer, but it must be a benefit they can apply in some other way to be meaningful. Simply raising the cost to exclude the poor isn’t a workable solution. It’s where we are now. The cost is their health and life.

America will not tolerate this continued “let them eat cake” or more precisely “let them be quick about dying” approach. A balance needs to be struck between extraordinary measures and basic healthcare. It’s not going to happen in the private sector. There is no profit motive or protection from lawsuits there. It’s a devise downward spiral.

People have to apply their common sense and pool their interests here.

If you take a look at what we have now what you will see is a system where people with insurance,through their job or privately, pick up the tab for those without. That is why you pay 12$ for a cotton ball. When people without coverage finally get sick enough they go to the ER where they get the most expensive care. They are being ill served and so are the rest of us paying the bill. What we have already IS socialist. The worst kind of socialism. That is without any oversite. Without any quaility or budgetary control. At least when the government is involved you can always vote the bastards out when they screw up.

It should be obvious why a healthcare system which involves hundreds of millions of ethnically and culturally diverse people, doctors, lawyers, medical researchers, insurance providers, employers and drug manufacturers cannot be compared to running the military or paving the roads.

Having first-hand experience with the medical systems of England and Germany, I can tell you it’s a lot easier if you have something like a broken limb or a throat infection to deal with, but infinitely worse if you’re talking about something like chemo or an organ transplant. Our system may not be perfect—it isn’t—but there are no hands you’d rather be if your health problems go beyond routine cuts and bruises.

As far as comparing life-expectancies goes, there are huge numbers of factors involved there besides a nation’s health care system. In fact, some of the places with the highest life expectancy in the world do not have anything resembling modern medical technology.

I agree that the healthcare system here should be improved to bring down costs and increase access, but throwing it all into the hands of the federal government would be a terrible, awful, nightmarish alternative.

Our current system has serious problems, but we don’t dare scrap it completely and put starting it over in the hands of the same people who do such a bang-up job when it comes to relatively easier tasks such as disaster relief after a hurricane or running the public schools.

How about this motto for the new federalized medical system: “Healthcare from the minds that brought you Katrina!”

Well, I’d prefer that we just shortcut all this banter and propose a full cradle to grave system for all of our human needs. Let’s get our jobs from the government, our food, our transportation, our healthcare, our education, etc. Why bother with the piddly jumps from social security to universal healthcare to job assignment and food rationing?

I’m sure that once the government controls every aspect of our lives that everyone will be happy, healthy, and equally wealthy.

Two ways to break this spiraling cycle of ever higher medical costs are:

1) increase the population of doctors and nurses dramatically. How?

For doctors, refund the costs of medical school for every graduate with a B+ average, and cap their salaries to $175,000 per year for 7 years requiring they work where demand is greatest for their first 2 years after internship. Then set them free.

For nurses (RN’s), a similar plan capping their salaries for 5 years at $75,000.

The competition by newer doctors and nurses offering quality, but far lower medical care costs, would force the veteran doctors rates to drop somewhat as well.

Supply and demand and competitive pricing would allow the government to recoup its medical school reimbursements and far more through lowered Medicare/Medicaid costs. Likely get better quality doctors too!

Some good ideas here except for a few quibbles.
(1) Capping doctor’s salaries at $175,000 per year for seven years soounds reasonable. But, let’s do some math: say 2 doctors go into a joint practice, we’ll say they are GP’s. Office costs: $350,000 per year for their salaries. 2 nurses at $75,000 per year is $150,000 per year. Rent, utilities, and office supplies, let’s say $25,000 per year. So far, $525,000 per year. Malpractice and other insurance: up to $75,000 per year, or more. So far: $600,000 per year. Add a couple of receptionists at $25,000 per year and we have a total of $650,000 dollars per year.
Now, let’s look at the supply side: 15 patients per day per doctor is 30 patients per day or 150 patients per week. Multiply by 50 weeks per year is 7500 patients per year. At an annual cost of $650,000, the per patient cost is 86.67.
Right now, my doctor charges $65.00 per visit. Most of the other doctors in this area of Eastern Kentucky charge about the same. Speciallists charge more, but the average family doctor is in the 50-75 dollar range. Where’s the savings?

Another question: for whom do the doctors work? Are they independent providers or government employees, or what? Who pays them?

Also, your final suggestion smacks of rationing. And that is the inevitable result of one source care. In your scenario, only the well-to-do would have full coverage. For the rest of us, “Sorry,Charlie”. Thanks, but I will stick with what we have, with some changes. But never one source medicine. I guess I am somewhat biased because the New Zealand medical system nearly killed my mother when she and my Dad were working over there. After two weeks of the best diagnostic tests available, the doctors told her they couldn’t tell what was wrong. She flew back home, saw her family doctor, 2 days later she was in the hospital being treated for a bacterial blood infection.

I fear that any move towards one source medical care would lead to many more instances of this.

Bush’s INsurance (he can’t pronounce that either, just like “nucular”!) plan is a sop to INsurance companies…we need to rid ourselves of all these INsurance companies who regularly post multi-million dollar profits quarterly, while denying legitimate claims and raising their rates. INsurance companies are a scam on all of us.

A National Health care System is the only way to fix the Health care problem in America. The present, Pay as you go system is broke and inadequate. Insurance Companies are fleecing Americans, higher and higher premiums, and less service. All the while CEOs, CFOs, etc. are making multi-million dollar salaries, coming from our monthly premiums, it has got too stop.
Corporations are closing more and more plants in America because of the never ending rising cost of Health Insurance, for one.
If our elected officials do not want to go for a National Health care plan, then we should stop paying for theirs. If they had to pay $900.00 a month for health insurance for them and their families, which includes $50.00 deductible Dr. visit, $50.00 prescription deductible or more. All subject to rise at the Insurance companies whim, believe me, after 6 mo. we would be on the way to a National Health Care Plan.

Good point about the cu$hy healthcare for politicians (not to mention their cu$hy retirement plans).

If healthcare providers don’t start dealing directly with their customers (instead of two unnecessary middlemen), the insurance companies are gonna find themselves with a lot fewer customers as government becomes the ONLY middleman.

Insurance premiums are getting so ridiculously high, it’s better for many to self-insure. Just put those premiums into an HSA or bank account, and invest it in something to keep inflation from eroding it.

Here’s something that doesn’t make any sense.
If you don’t have insurance, they hospitals and many healthcare providers charge you MORE.

But, if you have insurance, they beat the healthcare providers down on price, often to a small percentage of the original bill. I’ve seen bills of $15K be reduced to only $1K. What’s up with that? And, then, what insurance policies actually cover reveals a myriad of holes and things not covered. And with a 70%/30% or 80%/20% policy, what good is it when 20% of a fortune is still a fortune ? Medical insurance to be increasingly worthless, and doctors are losing customers due to getting squeezed by government meddling (Medicare) and millions of unnecessary middlemen in the insurnace business. Medicare providers are shooting themselves in the foot by letting the middlemen squeeze them, and insist on making medical decisions too.

You don’t seem to be very aware of what goes on in American hospitals and emergency rooms. I challenge you to have a heart attack and see how long you wait in the emergency room lobby. It’s just NOT done ANYWHERE. Heart attack victims do NOT wait in the lobby or go to the lobby. Time is critical, modern drugs that can greatly reduce problems must be delivered with great speed. You wont find a heart attack victim waiting in the lobby while a drunk and a person with the flu march into the ER ahead of them.

Why are you complaining about what Hospitals charge for services? They are forced to deliver the nations FREE health care in their emergency rooms to ALL UNINSURED. And to all those millions of illegals you let into the country. That IS the present day system and hopsitals MUST CHARGE for that, those who pay, pay for that. You think national health care will cost you less? You think rolling it all into a big government socialist system will be “more efficient”? LAUGH!

I’m all for harnessing the POWER of Ameican capitalism to provide some form of a national health care. I’m opposed to a Hillary Clinton socialist take over of the entire industry which she and Bill Clinton tried to do. Her first approach was actually written by a hard core socialist, would have taken over 1/7th of our nations economy, and was such a flop that the entire democratic party laughed it off the floor. I’m hearing radicals telling us it was a good first effort….What? It was a socialist flop, a nightmare, laughable. And that’s what the DEMOCRATS were saying!

Hillary was so disgraced that she virtually disappeared and the Republicans swept into the house partially on the outrageous attempt by Hillary to convert the US to a socialist state.

Hillary went into hiding and Clinton was actually able to pretend that he was the president for awhile.

National health care would have been a reality ten years ago if Hillary hadn’t tried to ram a radical liberal, socialist take over down the throats of a free and capitalist society.

The Canadian system is broken and any Canadian fleeing to America to get an operation he is “waiting” for in the Canadian Health Care Rationing system can tell you that.. Socialist models fail the world over. Lets learn from the FAILURES of others and succeed rather than failing at the liberal alter of politically correct socialist government. Lets go with what works and set aside the religion of the left wing politically correct.

Stephen, get some useful information and read the center column’s article about the State of the Union - Bankrupt America. Your biased ear apparently missed the import of Bush’s entire budget busting speech.

Having first-hand experience with the medical systems of England and Germany, I can tell you it’s … infinitely worse [than the USA(?)] if you’re talking about something like chemo or an organ transplant.

I “know” this womanmarine because I lived through it! The Clintons had swept into power and the republicans were BEAT and good. They were ready to come to the table and to give in on Health Care. Those of us in the MIDDLE who WANTED NATIONAL HEALTH CARE had a lot of hope, health care was clearly going to be vote FOR by not only democrats but the republicans too. They were too afraid to go against the voters on this.

Then Hillary took over. Told the republicans they could kiss off, that she was going to DICTATE the national health care policy. She followed that up by hiring a radical socialist to create the “new health care plan”. It was an abortion, a joke. A left wingers radical dream of turning the US into the Socialist Union of the United States.

Hillary squandered the only chance we were going to have to create national health care for a long time. She blew it by attempting a whacked out radical socialist take over of a huge portion of the US economy. And she managed to insult virtually everyone along the way.

The democrats laughed her out of politics when she dumped HER final plan on the table. It was a “grade-A” left wing socialist disaster. And America lost it’s chance.

Now the democrats and Bush have another chance, lets hope they don’t blow it. lets hops that Hillary doesn’t start hiring socialist lunatics again to dictate the radical lefts socialist take over of the US economy! That might destroy our shot at national health care for another 10 or 15 years. National health care cannot be DICTATED by either party. They must come together. Left wing hate, smears, socialism, and fear mongering will not provide us with national health care.

Bring business to the table. Bring the hospitals, the health care providers, employers, democrats, and republicans to the table. Look at what works abroad, look at what has FAILED abroad. And let them all compromise, let them come up with something better, something in keeping with our free enterprise capitalist economy that works so well but also has a heart for those with no health care.

History doesn’t repeat itself, but it certainly rhymes. If the left tries to ram another radical socialist plan down Americas throat, they will fail, again.

I had a heart attack a few years ago without insurance. Yes, they rushed me to the hospital and within the same day inserted two stints into blocked arteries. It bankrupted me. Only I was too poor to file bankruptcy. Since that time I have had to lie about my health to get a job, I run the risk of being uninsurable if I have more problems, I was released from the hospital within a week, without follow up care and unable to afford the medications my doctor prescribed. I nearly ended up homeless.

I have never even collected unemployment, let alone any kind of assisance in my life.

Becuase I still have trouble affording adequate care for this condition, I could well end up dead dibilitated, or running up another bill that my insurance company may decide is a pre existing condition and refuse to pay for.

It’s these kind uninformed rants that have put us taxpayers in the situation of paying for the most expensive care and the worst approach to healthcare.

When you talk about Hillary’s universal healthcare, you are talking about something that never made it to anywhere but the planning stages due to the Republican take over of Congress. Meanwhile nothing has been done..nothing. There was no socialist plan. That’s entirely bullshit.

The only outrage expressed was by the insurance lobby. But obviously they fooled you. You bought the “bought and paid” for outrage, hook, line and sinker.

A single payer system eliminates the middlemen that inflate costs and permit fraud. It strealines the massive paperwork that now exists. It doesn’t need to be and never was planned as “government run”. That is pure myth that you continue to spread.

You may as well be shouting, your a commie. It has the same moronic tone.

First off, You have your facts wrong. Telling me that I’m giving an “uniformed rant” was a bit silly because I had my facts correct and I’ll prove it. By the way, I understand how you messed up here. You probably have been listening to liberals, they tend to reinvent history to hide the failure of their agenda.

Let me give it to you from Wikipedia….and I’ll only add that clearly, as I stated, Hillarys plan died a horrible death, it was not supported by the democratic party. IN FACT, it was the democratic leadership that declared it dead, not a new republican congress as you apparently beleive. Hillarys socialist plan helped the republicans gain control after it was rejected by the democrats.

The man who declared the Hillary plan DEAD? Senate majority leader and DEMOCRAT George Mitchell. Hillarys plan was so far out there that not even her own party would accept it.

—————-http://en.wikipedia.org/wiki/Clinton_health_care_plan
Meanwhile, Democrats, instead of uniting behind the President’s original proposal, offered a number of competing plans of their own. Some criticized the plan from the left, preferring a Canadian-style single payer system.

On September 26, 1994, Senate Majority Leader George Mitchell announced that the plan was dead, at least for that session of Congress. The defeat weakened Clinton politically, and contributed to widespread public frustration with perceived Congressional gridlock.

Although these are terms I understand, in the UK these are all replaced with the words, National Health Service’ (NHS).

I can say as an ‘end-user’ that feeling unwell, I went to my doctor, sent to a consultant, was given a date to go to hospital, had operation (by the same consultant), allowed to recover, given aftercare appointments and pain relief and sent home to my family.

Total Bill : £0.00

In Europe, we pay out taxes for this service, and to my knowledge, I don’t know of anyone who has not been given any treatment when they require. As well as the physical treatment, we all get access to a large ‘mental’ health system where counselling, community care and respite, palliative care is there when and how you need it.

As the ‘wealthiest’ nation on earth to here the problems you have over there with the most basic of human rights, I feel sorry for you all and the anguish you must go through if you’re poorest get ill.

Stephen said: “I ‘know’ this womanmarine because I lived through it! The Clintons had swept into power and the republicans were BEAT and good. They were ready to come to the table and to give in on Health Care.”

Man o Man, are you wrong in this statement. Best cite a media link to support it, because I turned 57 today, and I lived through that period too, quite aware of politics. And NO, Republicans were adamantly attacking the plan with all the vigor and tact of Swiftboat Veterans.

It was dead on arrival because the Republican attacks on it were successful in swaying public opinion, and the Democratic Leadership, unlike this President, did, and do, read the polls.

Now, the American public is reawakening to the nightmare of our current broken system and asking themselves, “Maybe Hillary was right from the beginning, and the Republicans just snowed us on Universal Health Care like they snowed us on Iraq”.

The political winds have changed, Stephen, memories, no matter how tortured and deformed, are all that’s left you and the Republican Party. Memories of having had it all, and forced it to slip between your fingers like silly putty as you tried to strangle it with your grip to keep it by force, lies, and subterfuge.

Stephen, here is a link to one of the best recaps of how and why the Clinton plan failed, I have read to date.

I shall never forget the Harry and Louise commercials. They were paid for by none other than the conservatives of the Health Insurance lobby. Look where they have got us. 47 million without health insurance and growing by a million more each year under the Republicans. But, not to worry, their shareholders are making money hand over fist without those uninsureds, because Medicare is there to save the day and bankrupt all of our tomorrows, thanks to the Republican Rx plan and White House shield around the health insurance industry.

The republican plan since 1996 has been to so load the nation up on national debt as to make all safety net programs unsustainable. And for insurance that this would happen, they contrived the largest new public spending program in decades and the most expensive with their Medicare Rx plan with prohibitions to competitive bidding for the cost of drugs.

Your rebuttal of Stephens argument is more eloquent than I could do. While everyone knows that Wikipedia is only as good as it’s sources even his link makes clear the timing of the “failure” of Hillary’s plan. The sweep of the Republican “Backlash” was the genesis of this defeat. Money won out. As even I learned in elementary school, a bill is never the same from proposal to implementation. What Wikipedia smooths over is who funded the attack on Universal Healthcare and continues to fund the opposition today. While I believe some Libertarians opposed this on principal, the real deal was money politics. Follow the money, it’s a no brainer why this is opposed. Interestingly, a quasi Republican seems to think it will work in California.

Gergle, now the money is flowing to Democrats. You are impeccably correct. We must all now pay attention to the money flowing to Democrats and hold Democrats accountable to us and not the money.

A tall order, but, November was a watershed election in which Democrats didn’t win, Republicans lost, which means Independent voters have the power to switch parties every two years as needed until enough incumbents are gone, replaced by freshman who get the lesson of this new election dynamic.

The new dynamic is their votes (Independents) can’t be bought, so incumbents should not allow theirs to be bought. If they do, they lose the Independent vote and their reelection. It is the new wave of American politics. Please remember that you read it here first. :-)

Sorry David R. Remer. X million without healthcare insurance is not rationing. Rationing is when medical decisions are made on the basis of available funds versus social value. For example: I am 67 years old and retired(mostly). I need a heart transplant. Do I have as good a chance for the procedure as a 30 year old father of 3 with a good job? Rationing on the basis I have set up indicates the 30 year old will get the heart. Increase my age to 75 and my chances go down even more.

47 million withoout health insurance is, assuming all of them are uninsured because they cannot afford it and that is a tenuous argument, definitely a cause for concern, but not a cause for a massive new government bureaucracy.

I don’t understand your question. If you mean the creation of a department that will give us the same efficient, economical service the the DHS has provided, yes, that’s exactly what I mean. The Department of Homeland Security is one of the larger boondoggles that has provided an illusion of security.

Have you ever thought about the millions of people that work in the medical insurance business ?
Do you think they’re really providing you a necessary service?
Think again. Why pay all of these people unnecessarily?
Why not pay medical providers directly?

PROBLEM:
Government and insurance companies set up a system with themselves as middlemen, resulting in:

an over-complicated system, confused by too many parties with conflicts of interest;

insurance companies making medical decisions instead of your doctors;

medical care quality becoming increasingly unreliable and expensive;

complicated billing

ALL attempts to control costs have failed, since government or insurance companies are the guarantors of final payment.

SOLUTION:
Direct pay medcial FUND PLAN:

(1) administered by the healthcare providers themselves,

(2) that eliminates all reliance on either the government or insurance companies (middlemen) between health providers and patients,

(3) and eliminates insurance company bean-counters from making medical decisions;

(4) will help control costs, since government and insurance companies are not the guarantors of final payment,

(5) simplified billing

(6) will reduce fraud because there will no longer be an ignorant and indifferent middleman that doesn’t care about fraud, and merely raise insurance premiums or raise taxes;

CONCLUSION:

(1) Get rid of the middlemen (government and insurance companies).

(2) People pay directly into a medical fund that must be managed by the medical providers themselves, by people with medical knowledge and backgrounds (instead of being hired away by an insurance company to validate services and costs).

(3) It won’t solve everything, but it would be a big step in the right direction. Good business sense always says that unnecessary middlement always drive up costs. What we’re doing now isn’t working.

Many people suffer because of diagnosis incorrectly put initially why that physicians do not hurry to recognize the fault, whether there are the successful judicial claims, won by patients? Where about it is possible to esteem? WBR LeoP

My brain has the fog from chemo. It is very frustrating and embarrassing at times. It is a real experience and it is not the worst side effect just inconvenient in losing things and break in thought process. WBR LeoP